The Hair Color Issue

Everybody is greatly relieved when their hair grows back after chemotherapy. But its color and texture may be different than what you remember. Soft curls may require new products to manage them. Women who dyed their hair for years are often surprised by the amount of gray. It’s usually because the hair is just growing back in its natural, undyed state — which they may not have seen in a very long time!

About 75% of women in the United States use hair color. The practice goes at least as far back as ancient Egypt, when women used henna to change the color of their hair. It really moved into the mainstream culture in the 1920s and ’30s with the introduction of salon and home hair dye kits.

While you may not be quite certain what color your hair will be when you’re done, using a home kit is fairly easy. Or you can get it done at a salon, of course. Permanent hair dyes use a mix of prepackaged dye (usually your color plus ammonia) plus a “developer” (often hydrogen peroxide). When you massage the mixture into your hair, the developer reacts with the dye to open the hair cuticle (the protective outer covering of the hair shaft) and deposit color inside the hair. Other options include semi-permanent and temporary hair dyes, which stain hair without chemically changing the hair shaft, so they eventually wash out.

Concerns about chemicals

Each time you color your hair, you only absorb a small amount of dye into your system. But since hair coloring is a commitment that often involves repeated exposure over many years, you may be concerned about the potential long-term risk.

Questions about the safety of the chemicals used in hair dyes have been around almost as long as the hair dye kits themselves. It’s hard to accurately measure the risk. The coloring process uses a range of chemicals and each one could affect the body in a different way. There are differences in the quality and ingredients between brands and types of dyes. So it’s hard to test and compare them and come up with any meaningful results.

It’s also tough to make solid safety statements. In the 1970s, research linked chemicals in hair dyes to cancer when the dyes were tested on animals. So companies eliminated certain risky chemicals from the dye kits.

Concerns have persisted about the possible role of hair dye in cancer. But no clear link has ever been found between the personal use of hair dye and cancer in humans.

In 2011, a panel of experts at the Institute of Medicine analyzed multiple studies on the role of hair dye in breast cancer. They found no evidence of that use increased breast cancer risk.

Most of today’s commercial hair dyes still contain some chemicals that may be considered risky. So far, research has revealed this much about how hair dyes affect our bodies:

It’s important to be careful when applying the dye. Hair dyes can irritate skin and hurt eyes (if the product comes into direct contact with the eyes). The U.S. Food and Drug Administration (FDA) requires that chemical hair dyes carry a warning about this skin irritation and the potential risk of blindness if used for dyeing the eyelashes or eyebrows.

Many hair dyes contain coal tar, a mixture of chemicals derived from petroleum. Some people have been concerned that coal tar dyes increase the risk of cancer based on studies in small animals that were fed extremely high doses of coal tar. When coal tar dyes are applied to the skin — the more typical exposure we see in the hair dying process — there doesn’t appear to be a risk. Furthermore, studies of personal, at-home hair dye use in humans haven’t found any link to breast cancer.

Some studies have found a slight increase in the risk for bladder cancer among salon workers exposed to hair dyes on a regular basis. No increased risk for bladder cancer has been found among people who have their hair dyed.

Some studies have linked the personal use of hair dye with a very small increase in the risk of non-Hodgkin lymphoma and leukemia (cancers of the blood and bone marrow). The link was only in women who started dying their hair before 1980. Other studies have not found any link between hair dye use and these cancers.

Lead acetate is found in “progressive” dyes, such as Grecian Formula, which change the color of hair gradually from light or gray to black. Although most of these products are marketed to men, everyone should avoid any hair products with lead acetate. The European Union has classified it as a known human reproductive toxicant, which means it interferes with fertility and may alter normal development and functioning of the reproductive system. The Environmental Protection Agency has classified it as a known human respiratory toxicant, which mean it can irritate the lungs. Studies also suggest that it may cause cancer in the kidneys, stomach, and lungs.

Tips to color as safely as possible

Based on what we know so far — and based on the potential risks — you may want to change the way you color your hair to minimize your risk of breast and other cancers. Here are a few ideas to minimize risk:

Always follow the safety directions exactly. Do a patch test for allergic reactions every time before you color. Never dye your eyebrows or eyelashes, since getting dye in your eyes can irritate your eyes and possibly damage your vision.

Limit your exposure as much as possible. Wear gloves when you apply the dye. Don’t leave it on your head any longer than the directions say. When the coloring time is up, rinse your scalp and hair thoroughly with water. Then shampoo out any residue.

Don’t mix different coloring products. The mix of chemicals might be harmful.

P-phenylenediamine (PPD) is one particular coal tar dye used in many hair dyes, and darker hair dyes tend to contain more of it than lighter ones. PPD is banned from hair dyes in several European countries because of its potential to cause severe skin irritation. If you wish to avoid it, check the ingredients list.

Beware that brands marketed as “natural,” “organic,” or “non-toxic” may actually contain high-risk ingredients, although in smaller amounts. The same may be true for “no ammonia” or “no peroxide” products.

Whether or not it’s safe to color your hair during pregnancy is a question lots of women ask. Your body probably absorbs only a very small amount of hair dye when it’s applied, so it’s likely that very little chemicals, if any, would be able to get to your baby. But to be absolutely safe and avoid the worry, some women forgo coloring their hair during pregnancy. Talk with your doctor if you have questions or concerns.

If you dye your hair at home, choose a product with a low hazard rating in the EWG Database.

Permanent dyes appear to pose the most risk, but semi-permanent and temporary dyes can also contain possibly risky chemicals. Similarly, highlight treatments may be less risky due to lower absorption, but exposure to potentially risky chemicals is still possible. Typical highlight formulas contain hydrogen peroxide and ammonia, both of which can irritate the skin and lungs.

Consider using a plant-based dye, such as one made from henna, chamomile, wood, bark, or flowers. Completely plant-based dyes (containing no synthetic chemical ingredients) are low risk, and many women have had good experiences with them. Palette by Nature makes nonoxidative permanent plant-based dyes that are free of PPD, petroleum-based ingredients, peroxide, ammonia, parabens, and phthalates.

If you get your hair colored at a salon, know that most salon-only products are not listed in the EWG Database. Since the FDA doesn’t require an ingredients list on products intended for salon-use only, there’s rarely any published information on what’s in them. One option to ask your hair colorist about is the Organic Color Systems brand permanent hair dye, which is ammonia-free and certified organic and vegan.

Hearing all this may make you more open to accepting and possibly enjoying your own natural color. Are you ready for that? As I’ve gotten older, my friends and I have debated when — if ever — to stop coloring our hair and embrace the gray. Many women look positively stunning with gray hair, including some of my favorite celebrities — singer Emmylou Harris, writer Toni Morrison, and actresses Judi Dench and Jamie Lee Curtis.

How do you feel about coloring your hair? Have you explored safer hair color products? We’d love to hear about it.

Marisa Weiss, M.D. is the founder, president, and chief medical officer of Breastcancer.org, the world's most trafficked online resource for medically reviewed breast health and breast cancer information, reaching over 14 million visitors per year. A breast cancer oncologist with over twenty years of active practice in the Philadelphia region, Dr. Weiss is regarded as a visionary advocate for her innovative and steadfast approach to informing, empowering, and treating patients with breast cancer.

Comments

Claire_in_Seattle says:

I consider great hair color one of the wonders of modern technology. My joke about “post chemo hair color” is that it’s exactly the same shade of Feria as before! Anyway, I keep it colored, and I love the way it looks when freshly done.

Actually, having fab hair is one of the bonuses of this whole breast cancer trip. It was long overdue for updating, and with a trip through chemo, I was finally forced to DO SOMETHING. I think it looks fab now, and I pay good money to have someone who knows what they are doing cut it. I color it myself and have the routine down.

I realize I am vain, but I have found that being able to look fab post treatment was really helpful in my recovery (the mental part). I did need to rethink my “look” and I went for chic and contemporary. I also did a number of makeup consultations to get that down too, I am still grateful to Lizzie for all her help and patience. Anyway, I wanted this time in my life to be all about fabulousless, and I wasn’t ready to accept anything else.

And I really do think that, in the case of hair color, the risk is miniscule compared to the benefits. To say nothing of being happy as opposed to scowling when I look in the mirror every day. Now….grey, dried out looking, scraggly, dead looking…..I can predict with 100% certainty how that would make me feel. And I am not going there.

BarbRocks says:

I am kind of late commenting to this story. Losing my hair wasn’t a big deal for me… I have a really cute head and pretty earrings. I have to admit, I did miss those nose hairs!

When my hair come back, all curly and pretty, I couldn’t wait to color it. I have to say, it was the biggest “pick me up!” I felt young and colorful again. With all the chemo and radiation and all the rest, I felt gray and tired and I looked gray and tired…. Hair Color Rocks! Do what you can to make yourself feel better. Hair Color and a massage… Life is Good!

BlueFox says:

Temporary hair colourants seem to have less harsh chemicals than semi-permanent and permanent ones. They worked well for me and got rid of all the Chemo White…